Prevalence and risk factors associated with herpes simplex virus-2 infection in a contemporary cohort of HIV-infected persons in the United States
Pragna Patel, Tim Bush, Kenneth H Mayer, Sheila Desai, Keith Henry, Edgar Turner Overton, Lois Conley, John Hammer, John T Brooks, SUN Study Investigators, John T Brooks, Praga Patel, Lois Conley, Tim Bush, Kathleen Wood, Rose Baker, Cheryl Akridge, John Hammer, Tara Kennedy, Barbara Widick, Billie Thomas, Ken Lichtenstein, Cheryl Stewart, Keith Henry, Jason Baker, Rachel Prosser, Edie Gunderson, Miki Olson, John Hall, Frank Rhame, Mark Olson, Eve Austad, Hal Martin, Meaghan Morton, Cheri Murch, Charles Carpenter, Susan Cu-Uvin, Kenneth Mayer, Erna Milunka Kojic, Jennifer Florczyk, Sara Metzler, Patricia D'Aiello, E Turner Overton, Don Connor, Lisa Kessels, Mariea Snell, Sara Hubert, Dorothea Dedeaux-Turner, Kenneth Griffie, Pragna Patel, Tim Bush, Kenneth H Mayer, Sheila Desai, Keith Henry, Edgar Turner Overton, Lois Conley, John Hammer, John T Brooks, SUN Study Investigators, John T Brooks, Praga Patel, Lois Conley, Tim Bush, Kathleen Wood, Rose Baker, Cheryl Akridge, John Hammer, Tara Kennedy, Barbara Widick, Billie Thomas, Ken Lichtenstein, Cheryl Stewart, Keith Henry, Jason Baker, Rachel Prosser, Edie Gunderson, Miki Olson, John Hall, Frank Rhame, Mark Olson, Eve Austad, Hal Martin, Meaghan Morton, Cheri Murch, Charles Carpenter, Susan Cu-Uvin, Kenneth Mayer, Erna Milunka Kojic, Jennifer Florczyk, Sara Metzler, Patricia D'Aiello, E Turner Overton, Don Connor, Lisa Kessels, Mariea Snell, Sara Hubert, Dorothea Dedeaux-Turner, Kenneth Griffie
Abstract
Background: We compared the herpes simplex virus type 2 (HSV-2) seroprevalence in a contemporary HIV cohort with the general US population and determined risk factors for HSV-2 infection among HIV-infected persons.
Methods: The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN) Study is a prospective observational cohort of 700 HIV-infected adults enrolled in 4 U.S. cities between 2004 and 2006. At baseline, participants completed a behavioral risk questionnaire and provided specimens for HSV-2 serology. We calculated HSV-2 seroprevalence, standardized by age, gender, and race among HIV-infected persons compared with the general US adult population, using data from the National Health and Nutrition Examination Survey from 2003 to 2006. We examined risk factors associated with HSV-2 infection among HIV-infected persons using multivariate logistic regression.
Results: Among 660 (94%) SUN participants with adequate specimens for HSV-2 serologic testing, 548 (83%) were 20 to 49 years old (median age, 39 years; 77% male; 59% non-Hispanic white; median CD4 count, 470 cells/mm; 74% with HIV RNA viral loads <400 copies/mL). HSV-2 seroprevalence was significantly higher among HIV-infected adults (59.7%, 95% confidence interval: 55.8-63.6) compared with the general US population (19.2%, 95% confidence interval: 17.5-21.1). In multivariate analysis, we found that older age, female gender, black non-Hispanic race/ethnicity, being currently unemployed, high-risk anal HPV infection, and longer duration since HIV diagnosis were associated with significantly higher odds of HSV-2 infection.
Conclusion: HSV-2 seroprevalence is 3 times as high among HIV-infected adults as in the general U.S. population. Clinicians should be aware that increased risk for HSV-2 infection was distributed broadly among HIV-infected persons and not limited to those with high-risk sexual behaviors.
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Source: PubMed